Fossa pterygopalatina ve ıntraoral bağlantılarının anatomik değerlendirmesi
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Fossa pterygopalatina (FPP), içinde çok sayıda yapı bulunduran ve farklı geçiş yolları sayesinde çevresindeki önemli yapılarla bağlantısı olan bir bölgedir. Bu durum fossayı klinikte cerrahi işlemler açısından önemli bir yapı haline getirmektedir. Fossa pterygopalatina ve çevresine yapılan cerrahi işlemlerin ve bu işlemler öncesi verilen anestezi miktarının bu bölgede bulunan önemli yapıların hasar görme riskine karşı doğru ve güvenilir olması gerekmektedir. Yapılan işlemlerin riskini en aza indirmek bu bölge anatomisinin iyi bilinmesi ile mümkündür. Çalışmamızda fossa pterygopalatina ve oral bağlantılarının yaşa, cinsiyete ve sağ-sol taraflara göre morfolojisinin incelenmesi ve morfometrik ölçümlerinin belirlenmesi amaçlanmıştır. Bu çalışmaya yaşları 18 ile 98 arasında değişen 199 birey (99 erkek, 100 kadın) dahil edildi. Bilgisayarlı Tomografi kullanılarak aksial, coronal ve sagittal kesitlerde; fossa pterygopalatina hacmi, canalis palatinus major uzunluğu (CPM), yönü ve fossa arasında oluşan açı, CPM- palatum durum horizontal düzlemi (PDHD) arası açı, foramen palatinum majus'un (FPM) transvers ve antero-posterior yönde çapları, lokalizasyonu ve şekli retrospektif olarak incelenmiştir. Çalışmamızda fossa pterygopalatina hacmi, FPM kısa ve uzun çapları, FPM - midsagittal düzlem (MSD) arası mesafe ve A- spina nasalis posterior (SNP) mesafesi erkeklerde kadınlara göre istatistiksel olarak anlamlı şekilde daha büyük bulunmuştur (p<0.05). CPM-PDHD arası açı ise kadınlarda erkeklere göre istatistiksel olarak daha büyüktü (p<0.05). CPM uzunluğunda cinsiyetler arası anlamlı fark bulunamamıştır. Kadın ve erkeklerde sağ-sol taraflar arası yapılan karşılaştırmada tüm parametreler için anlamlı farklılık olmadığı tespit edilmiştir (p>0.05). Sağ foramen şekilleri arasında en sık görülen FPM şekli erkeklerde %77,8, kadınlarda %71,00 oranında oval olurken en az görülen FPM şekli ise erkeklerde ve kadınlarda %1 oranında yuvarlak olmuştur. Sol foramen şekilleri arasında ise erkeklerde en sık görülen sol FPM şekli %74,7, kadınlarda %64,00 oranında oval iken en az görülen FPM şekli erkeklerde %5,1, kadınlarda %2 oranında yuvarlak olmuştur. Canalis palatinus major'un sagittal düzlemdeki yönüne bakıldığında sağ CPM yönü arasında erkeklerde %89,9 kadınlarda %88,0 oranında büyük çoğunluğunun anteroinferior yönünde olduğu belirlenmiştir. Sol CPM yönünde erkeklerde %97,0, kadınlarda %91,0 oranında en sık görülen yön anteroinferior olurken erkeklerde ve kadınlarda sol tarafta canalis palatinus major'un önce inferior sonra anteroinferior yönde ilerlemesine rastlanmamıştır. Türk populasyonunda yeterli çalışma bulunmayan bu konudaki çalışmamızın gerek diğer ırklarda yapılanlarla karşılaştırılması gerekse yapılacak çalışmalara ışık tutması açısından önemli olacağı kanaatindeyiz.
terygopalatine fossa (PPF) is a region that contains many structures and is connected with important structures around it through different passageways. This situation makes the fossa an important structure in terms of surgical procedures in the clinic. The surgical procedures performed in the pterygopalatine fossa and the amount of anesthesia given before these procedures must be accurate and reliable against the risk of damage to important structures in this region. It is possible to minimize the risk of the procedures performed by knowing the anatomy of this region well. In our study, we aimed to examine the pterygopalatine fossa and its oral connections morphologically and morphometrically according to age, gender and right-left sides. 199 individuals (99 males, 100 females) aged between 18 and 98 were included in this study. In axial, coronal and sagittal sections using computed tomography images; pterygopalatine fossa volume, greater palatine canal (GPC) length, direction and angle formed between the fossa, angle between GPC and palatum state horizontal plane (PDHD), greater palatine foramen (GPF) transverse and antero-posterior diameters, localization and shape were examined retrospectively. In our study, fossa pterygopalatina volume, GPF short and long diameters, GPF - midsagittal plane (MSD) distance and A- posterior nasal spine (PNS) distance were found to be statistically significantly larger in men than in women (p <0.05). The angle between GPC-PDHD was statistically greater in women than in men (p <0.05). There was no significant difference between genders in GPC length (p> 0.05). There was no significant difference in all parameters in the comparison between right and left sides of women and men (p> 0.05). The most common GPF shape in the right foramen was oval at 77.8% in men and 71.00% in women, while the least common GPF shape was round in men and 1% in women. The most common GPF shape in left foramen was oval at 74.7% in men and 64.00% in women, while the least common GPF shape was round at 5.1% in men and 2% in women. When the direction of the greater palatine canal in the sagittal plane was examined, it was determined that the right GPC direction was 89.9% in males and 88.0% in females were in the anteroinferior direction. While the most common left GPC direction was in the anteroinferior direction with a rate of 97.0% in men and 91.0% in women, it was not observed that the canalis palatinus major on the left side first inferior and then anteroinferior in men and women. We believe that our study on this subject, which does not have enough studies in the Turkish population, will be important in terms of both comparing with other races and shedding light on the studies to be done.
terygopalatine fossa (PPF) is a region that contains many structures and is connected with important structures around it through different passageways. This situation makes the fossa an important structure in terms of surgical procedures in the clinic. The surgical procedures performed in the pterygopalatine fossa and the amount of anesthesia given before these procedures must be accurate and reliable against the risk of damage to important structures in this region. It is possible to minimize the risk of the procedures performed by knowing the anatomy of this region well. In our study, we aimed to examine the pterygopalatine fossa and its oral connections morphologically and morphometrically according to age, gender and right-left sides. 199 individuals (99 males, 100 females) aged between 18 and 98 were included in this study. In axial, coronal and sagittal sections using computed tomography images; pterygopalatine fossa volume, greater palatine canal (GPC) length, direction and angle formed between the fossa, angle between GPC and palatum state horizontal plane (PDHD), greater palatine foramen (GPF) transverse and antero-posterior diameters, localization and shape were examined retrospectively. In our study, fossa pterygopalatina volume, GPF short and long diameters, GPF - midsagittal plane (MSD) distance and A- posterior nasal spine (PNS) distance were found to be statistically significantly larger in men than in women (p <0.05). The angle between GPC-PDHD was statistically greater in women than in men (p <0.05). There was no significant difference between genders in GPC length (p> 0.05). There was no significant difference in all parameters in the comparison between right and left sides of women and men (p> 0.05). The most common GPF shape in the right foramen was oval at 77.8% in men and 71.00% in women, while the least common GPF shape was round in men and 1% in women. The most common GPF shape in left foramen was oval at 74.7% in men and 64.00% in women, while the least common GPF shape was round at 5.1% in men and 2% in women. When the direction of the greater palatine canal in the sagittal plane was examined, it was determined that the right GPC direction was 89.9% in males and 88.0% in females were in the anteroinferior direction. While the most common left GPC direction was in the anteroinferior direction with a rate of 97.0% in men and 91.0% in women, it was not observed that the canalis palatinus major on the left side first inferior and then anteroinferior in men and women. We believe that our study on this subject, which does not have enough studies in the Turkish population, will be important in terms of both comparing with other races and shedding light on the studies to be done.
Açıklama
Anahtar Kelimeler
Bilgisayarlı Tomografi, Canalis Pterygopalatinus Major, Fossa Pterygopalatina, Morfometri, Computed Tomography, Greater Palatine Canal, Morphometry, Pterygopalatine Fossa
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Aymelek, K. (2020). Fossa pterygopalatina ve ıntraoral bağlantılarının anatomik değerlendirmesi. (Yüksek Lisans Tezi). Selçuk Üniversitesi, Sağlık Bilimleri Enstitüsü, Konya.